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Individual

CARMON R RUDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
139 SAINT MATTHEWS AVE, LOUISVILLE, KY 40207-3117
(502) 895-3774
Mailing address
6708 HARRODS VIEW CIR, PROSPECT, KY 40059-9473
(502) 228-3068

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5750
KY

Other

Enumeration date
04/18/2007
Last updated
07/08/2007
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